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dermatology > blistering skin disorder / miscellaneous skin disorders > Flashcards

blistering skin disorder / miscellaneous skin disorders Flashcards

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Dermatology Board Prep flashcards
1
Q

blistering skin disorders - types

A
  1. pemphigus vulgaris
  2. Bullous pemphigoid
  3. dermatitis herpetiformis
  4. Erythema multiforme
  5. Steven-Johnson syndrome
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2
Q

pemphigus vulgaris - mechanism

A

autoimmune skin disorder with IgG antibody against desmoglein (component of desmosomes) (stratum spinosum)

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3
Q

pemphigus vulgaris - appearance

A

Flaccid intraepidermal bullae caused by acantholysis

ORAL MUCOSA ALSO INVOLVED

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4
Q

pemphigus vulgaris - immunofluorescence

A

antibodies around epidermal cells in a reticular (net like) pattern

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5
Q

pemphigus vulgaris - sign

A

Nikolsky sign +

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6
Q

Nikolsky sign +

A

separation of epidermis upon manual stroking of skin

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7
Q

pemphigus vulgaris - course

A

potentially fatal

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8
Q

bullous pemphigoid - mechanism

A

IgG antibody against hemidesmosomes (epidermal basement mambrane)

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9
Q

bullous pemphigoid - Nikolsky sign

A

negative

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10
Q

bullous pemphigoid - immunofluorescence

A

linear pattern at epidermal-dermal junction

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11
Q

bullous pemphigoid - appearance

A

tense bilsters (CONTAINING EOSINOPHILS) affect skin but spares oral mucosa

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12
Q

dermatitis herpetiformis - appearance

A

pruritic papules, vesicles and bullae (often found on elbows)

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13
Q

dermatitis herpetiformis - pruritic papules, vesicles and bullae are often found on

A

elbows

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14
Q

dermatitis herpetiformis - associated with

A

celiac disease

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15
Q

dermatitis herpetiformis - mechanism

A

deposits of IgA at tips of dermal papillae (associated with celiac disease)

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16
Q

pemphigus vulgaris vs bullous pemphigoid - according course

A

pemphigus vulgaris –> potentially fatal

bullous pemphigoid –> less severe

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17
Q

pemphigus vulgaris vs bullous pemphigoid - according mechanism

A

pemphigus vulgaris –> IgG against desmoglein

bullous pemphigoid –> IgG against hemidesmosomes

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18
Q

pemphigus vulgaris vs bullous pemphigoid - Nikolsky sign

A

pemphigus vulgaris –> +

bullous pemphigoid –> -

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19
Q

pemphigus vulgaris vs bullous pemphigoid - immunofluorescense

A

pemphigus vulgaris –> reticular (net like)

bullous pemphigoid –> linear pattern

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20
Q

Erythema multiforme is associated with

A
  1. infection 2. drugs 3. cancers 4. autoimmune diseases
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21
Q

Erythema multiforme - infections?

A
  1. Mycoplasma pneumoniae

2. HSV

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22
Q

Erythema multiforme - drugs?

A
  1. sulfa drugs
  2. β-lactams
  3. phenyntoin
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23
Q

Erythema multiforme - presents with

A

multiple types of lesions - macules, papules, vesicles, target lesions

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24
Q

Erythema multiforme - target lesions?

A

look like targets with multiple rings and dusky center showing epithelial disruption

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25
Q

Steven - Johnson syndrome is symptoms

A
  1. fever 2. bullae formation 3. necrosis

4. sloughing of skin 5. targetoid lesions may appear

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26
Q

Steven - Johnson syndrome - prognosis

A

high mortality rate

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27
Q

Steven - Johnson syndrome - skin manifestations

A
  1. bullae formation 2. necrosis

3. sloughing of skin 4. targetoid lesions may appear

28
Q

Steven - Johnson syndrome - typically involves

A

2 mucous membranes

29
Q

Steven - Johnson syndrome -targetoid skin lesions may appear, as seen in

A

erythema multiforme

30
Q

Steven - Johnson syndrome is usually associated with (is a result of)

A

adverse drug reaction

31
Q

more severe form of Steven - Johnson syndrome

A

toxic epidermal necrolysis

32
Q

toxic epidermal necrolysis - characteristic

A

more severe form of Steven - Johnson syndrome

>30% of the body surface

33
Q

Steven - Johnson syndrome with >30% of the body surface

A

toxic epidermal necrolysis

34
Q

Steven - Johnson syndrome with 10%-30% of the body surface

A

Steven - Johnson syndrome-toxic epidermal necrolysis

35
Q

Acanthosis nigricans are associated with

A
  1. hyperinsulinemia (diabetes, obesity, cushing)

2. visceral malignancy (eg, gastric adenocarcinoma)

36
Q

Acanthosis nigricans - mechanism

A

epidermal hyperplasia causing, SYMMETRIC, hyperpigmented thickening of skin, esp in axilla or neck

37
Q

Acanthosis nigricans - MC areas

A

axilla

neck

38
Q

Acanthosis nigricans - skin manifestations

A

symmetric, hyperpigmented thickening of skin, especially in axilla or on neck

39
Q

Squamous cells carcinoma (SCC) of the skin - precursor lesion

A

Actinic keratosis

40
Q

Actinic keratosis - risk of SCC is proportional to

A

degree of epithelial dysplasia

41
Q

Actinic keratosis is caused by

A

sun exposure

42
Q

Actinic keratosis appearance

A

scaly plaque, hyperkeratotic

small, rough, erythematous or brownish papules or plaques

43
Q

Erythema nodosum are .. (and histological area)

A

painful inflammatory lesions of subcutaneous fat

44
Q

Erythema nodosum - MC area of the body

A

anterior shins

45
Q

causes of Erythema nodosum

A
  1. idiopathic 2. sarcoidosis 3. coccidioidomycosis 4. histoplasmosis 5. TB 6. streptococcal infections 7. leprosy 7. Inflammatory bowel disease
46
Q

Sunburn?

A

acute cutaneous inflammatory reaction due to excessive UV irradiation

47
Q

Sunburn is due to

A

excessive UV irradiation

48
Q

Sunburn causes (pathophysiology)

A

DNA mutations –> apoptosis of keratinocytes

49
Q

Ultraviolet A is dominant in

A

tanning (skin color is darkened) and photoaging (premature aging of the skin due to chronic exposure of skin to ultraviolet)

50
Q

Ultraviolet B is dominant in

A

sunburn

51
Q

Ultraviolet A and B - nm?

A

A: 400-320 nm
B: 320-290 nm

52
Q

sunburn can lead to

A
  1. impetigo

2. skin cancers

53
Q

pityriasis rosea - skin manifestations

A

Herald patch followed days later by other scaly erythematous plaques, often in a Christmas tree distributions
Multiple plaques with collarette scale

54
Q

pityriasis rosea - treatment

A

self-resolving in 6-8 weeks

55
Q

tense blisters containing eosinophils - skin disorder

A

bullous pemphigoid

56
Q

skin disorder associated with IgA deposition at tips of dermal papillae

A

dermatitis herpetiformis

57
Q

skin disorder associated with celiac disease

A

dermatitis herpetiformis

58
Q

pemphigus vulgaris is caused by

A

acantholysis

59
Q

Lichen planus - skin manifestation

A

mneominc 6Ps

  1. Pruritic 2. Purple
  2. Polygonal Planar Papules 4. Plaques
60
Q

Liches Planus is associated with

A

hepatis C

61
Q

hepatis C - skin disease associated

A

Liches Planus

62
Q

Liches Planus - histology

A

Sawtooth infiltrate of lymphocytes at dermal - epidermal junction

63
Q

Liches Planus - mucosa involvement as

A

Wickham striae (reticular white lines)

64
Q

Wickham striae appearance

A

reticular white lines

65
Q

sulfa drugs - skin disease?

A

erythema multiform

66
Q

dermatitis herpetiformis - treatment

A
  1. gluten free diet

2. dapsone

67
Q

tense blisters of bullous pemphigoid contain

A

eosinophils

dermatology (9 decks)

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